ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 315

Assessing the Value of Whole Body Magnetic Resonance Imaging As to Clinical Examination to Predict Remission and Relapse in Early Peripheral Spondyloarthritis

Thomas Renson1, Ann-Sophie De Craemer1, Philippe Carron1, Simon Krabbe2, Lennart Jans3, Manouk de Hooge4, Peggy Jacques1, Mikkel Østergaard5, Dirk Elewaut1 and Filip van Den Bosch6, 1Department of Rheumatology, Ghent University Hospital, Ghent, 9000, Belgium, 2Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Rigshospitalet, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark, 3Department of Radiology, Ghent University Hospital, Ghent, Belgium, 4Ghent University Hospital, Ghent, Belgium, 5Center for Rheumatology and Spine Diseases, Copenhagen Center for Arthritis Research, Rigshospitalet, Denmark, Copenhagen, Denmark, 6Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Sunday, October 21, 2018

Title: Imaging of Rheumatic Diseases Poster I: MRI

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Evaluation of disease activity and treatment response in peripheral spondyloarthritis (pSpA) is currently based upon clinical findings, laboratory tests and ultrasound examination. Whole-body magnetic resonance imaging (WB MRI) is a relatively new imaging technique that could offer additional information regarding the inflammatory status of joints, entheses and soft tissues. The objective of this study is to determine A) the value of WB MRI, performed at baseline, in relation to clinical remission in pSpA and B) the value of subclinical inflammation, detected by WB MRI, at time of clinical remission in predicting flare after treatment withdrawal in pSpA.

Methods: Clinical REmission in peripheral SPondyloArthritis (CRESPA) is a placebo-controlled trial of golimumab treatment in 60 early (symptom duration < 12 weeks) pSpA patients (pts). All pts underwent a modified WB MRI at baseline and at the time of clinical remission when treatment was withdrawn. The WB MRI was performed by scanning multiple locations individually (using different coils) in order to investigate SpA-specific locations in detail. Several anatomical sites of pelvis and lower limbs were evaluated for bone marrow edema (BME), synovitis and soft tissue inflammation (STI) by 3 readers, giving a score of 0 (no abnormalities), 1 (mild), 2 (moderate) or 3 (severe). For each site a mean of the scores of the 3 readers was calculated. For each patient at each time point, we calculated a sum score for synovitis, STI and BME separately adjacent to a total sum score. Changes scores are baseline minus remission sum scores.

Results: Pts reaching remission had lower baseline MRI synovitis (3,0 vs. 3,6), STI (2,1 vs. 2,2), BME (1,8 vs. 2,9) and total sum scores (7,0 vs. 8,7) then the non-remission group. However, these differences lacked statistical significance. At the time of clinical remission 10/45 (22%) and 11/45 (24%) pts had residual talocrural and subtalar synovitis respectively. However, there was no statistically significant difference between patients who relapsed after treatment withdrawal and those who remained in remission concerning synovitis sum scores (p = 0.497) as well as BME sum scores (p = 0.741) and STI sum scores (p = 0.131) at time of clinical remission (Table 1).

Table 1: BME, synovitis and STI presence in early pSpA pts who relapsed and did not relapse after stopping golimumab therapy

Patients relapsed (n=20)

Patients not relapsed (n=25)

BME at baseline

1.9 (±2.4)

2.0 (±2.4)

BME at follow-up

1.3 (±1.1)

1.4 (±1.9)

Synovitis at baseline

2.4 (±2.9)

3.6 (±3.9)

Synovitis at follow-up

1.2 (±1.4)

1.4 (±1.4)

STI at baseline

1.9 (±2.4)

2.3 (±2.3)

STI at follow-up

0.9 (±0.7)

1.1 (±1.1)

Conclusion: There was no significant difference in inflammatory burden on baseline WB MRI between patients going into remission and those with ongoing disease activity. At remission, a substantial part of the participants showed residual ankle synovitis on MRI. However, residual inflammatory lesions detected by MRI did not differ significantly between patients who relapsed after treatment withdrawal and those in ongoing remission.

Disclosure: T. Renson, None; A. S. De Craemer, None; P. Carron, None; S. Krabbe, None; L. Jans, None; M. de Hooge, None; P. Jacques, None; M. Østergaard, None; D. Elewaut, None; F. van Den Bosch, None.

To cite this abstract in AMA style:

Renson T, De Craemer AS, Carron P, Krabbe S, Jans L, de Hooge M, Jacques P, Østergaard M, Elewaut D, van Den Bosch F. Assessing the Value of Whole Body Magnetic Resonance Imaging As to Clinical Examination to Predict Remission and Relapse in Early Peripheral Spondyloarthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/assessing-the-value-of-whole-body-magnetic-resonance-imaging-as-to-clinical-examination-to-predict-remission-and-relapse-in-early-peripheral-spondyloarthritis/. Accessed .

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessing-the-value-of-whole-body-magnetic-resonance-imaging-as-to-clinical-examination-to-predict-remission-and-relapse-in-early-peripheral-spondyloarthritis/